Remote guidance

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Remote guidance, in the medical context, refers to the supervision or guidance of a medical task, usually a procedure or test, from a remote location. This falls in the realm of real time telemedicine applications. By way of example, a radiologist may guide an ultrasound examination from a remote location. As such, the proximate requisite expertise to accomplish a medical task is significantly diminished. In the previous example, a diagnostic quality ultrasound can be accomplished by non-medically trained individuals manipulating an ultrasound device located with the patient under guidance from a remote location. This is an example of teleradiology If appropriately configured, the remote guidance can originate from another room or floor in the same building, too as far away as another continent or even planet. NASA researchers have successfully demonstrated remote guidance of diagnostic level cardiac ultrasonography using ultrasound on the space station, non-medical astronauts performing the exam as guided by a terrestrially located expert.

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Remote diagnostics

Remote diagnostics refers to a real time telemedical application that achieves diagnostic level quality and information exchange. In this sense, it refers to an expectation for quality sufficient for making or excluding a medical diagnosis. In the telemedical context specific to radiologic images these images often are consistent with the DICOM standard. Given bandwidth issues universally plaguing the healthcare environment imagery beyond still images and brief video has not yet become standard expectation of care environments or PACS systems. Ultrasound scanning commonly utilized for abdomen, musculoskeletal, pelvis, gynecologic, cardiac and vascular evaluations has shown potential for remote diagnosis only of late.

More general Remote Diagnostics (RD) refers to detecting which fault or faults are present in a system, body of object, from a distance. Examples of use: aeroplanes, spacecraft, Formula 1 and major assets such as ships, trains etc. In cases where corrective actions are also made, the term 'Remote Diagnostic & Maintenance' is more appropriate.

Technical aspects

While still imagery can be e-mailed and forwarded in a multitude of methods, video product of medical devices has typically not been available for remote interaction. Recent improvements in scanning devices, for example ultrasound machines has facilitated this new capability. The inclusion of the VGA output gives the opportunity for frame grabber devices to stream such outputs to the internet.

Related Research Articles

<span class="mw-page-title-main">Medical ultrasound</span> Diagnostic and therapeutic technique

Medical ultrasound includes diagnostic techniques using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs, to measure some characteristics or to generate an informative audible sound. The usage of ultrasound to produce visual images for medicine is called medical ultrasonography or simply sonography, or echography. The practice of examining pregnant women using ultrasound is called obstetric ultrasonography, and was an early development of clinical ultrasonography. The machine used is called an ultrasound machine, a sonograph or an echograph. The visual image formed using this technique is called an ultrasonogram, a sonogram or an echogram.

<span class="mw-page-title-main">Radiology</span> Branch of medicine specialising in medical imaging

Radiology is the medical specialty that uses medical imaging to diagnose diseases and guide treatment within the bodies of humans and other animals. It began with radiography, but today it includes all imaging modalities. This includes technologies that use no ionizing electromagnetic radiation, such as ultrasonography and magnetic resonance imaging), as well as others that do use radiation, such as computed tomography (CT), fluoroscopy, and nuclear medicine including positron emission tomography (PET). Interventional radiology is the performance of usually minimally invasive medical procedures with the guidance of imaging technologies such as those mentioned above.

Medical physics deals with the application of the concepts and methods of physics to the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. Since 2008, medical physics has been included as a health profession according to International Standard Classification of Occupation of the International Labour Organization.

<span class="mw-page-title-main">Medical imaging</span> Technique and process of creating visual representations of the interior of a body

Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging.

<span class="mw-page-title-main">Echocardiography</span> Medical imaging technique of the heart

Echocardiography, also known as cardiac ultrasound, is the use of ultrasound to examine the heart. It is a type of medical imaging, using standard ultrasound or Doppler ultrasound. The visual image formed using this technique is called an echocardiogram, a cardiac echo, or simply an echo.

<span class="mw-page-title-main">Obstetric ultrasonography</span> Use of medical ultrasonography in pregnancy

Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus (womb). The procedure is a standard part of prenatal care in many countries, as it can provide a variety of information about the health of the mother, the timing and progress of the pregnancy, and the health and development of the embryo or fetus.

<span class="mw-page-title-main">Auscultation</span> Listening to the internal sounds of the body, usually using a stethoscope

Auscultation is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems, as well as the alimentary canal.

<span class="mw-page-title-main">Pericardiocentesis</span> Procedure where fluid is aspirated from the pericardium

Pericardiocentesis (PCC), also called pericardial tap, is a medical procedure where fluid is aspirated from the pericardium.

<span class="mw-page-title-main">Sonographer</span> Healthcare professional specialization

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<span class="mw-page-title-main">Ian Donald</span> English physician

Ian Donald was an English physician who pioneered the diagnostic use of ultrasound in obstetrics, enabling the visual discovery of abnormalities during pregnancy. Donald was born in Cornwall, England, to a Scottish family of physicians. He was educated in Scotland and South Africa before studying medicine at the University of London in 1930, and became the third generation of doctors in his family. At the start of World War II, Donald was drafted into the Royal Air Force as a medical officer, where he developed an interest in radar and sonar. In 1952, at St Thomas' Hospital, he used what he learned in the RAF to build a respirator for newborn babies with respiratory problems.

<span class="mw-page-title-main">3D ultrasound</span> Rendering technique in medical imaging

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<span class="mw-page-title-main">Abdominal ultrasonography</span> Type of medical scan

Abdominal ultrasonography is a form of medical ultrasonography to visualise abdominal anatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall. For this reason, the procedure is also called a transabdominal ultrasound, in contrast to endoscopic ultrasound, the latter combining ultrasound with endoscopy through visualize internal structures from within hollow organs.

Emergency ultrasound employing point-of-care ultrasound (POCUS) is the application of ultrasound at the point of care to make immediate patient-care decisions. It is performed by the health care professional caring for the injured or ill persons. This point-of-care use of ultrasound is often to evaluate an emergency medical condition, in settings such as an emergency department, critical care unit, ambulance, or combat zone.

Physician self-referral is a term describing the practice of a physician ordering tests on a patient that are performed by either the referring physician himself or a fellow faculty member from whom he receives financial compensation in return for the referral. Examples of self-referral include an internist performing an EKG, a surgeon suggesting an operation that he himself would perform, and a physician ordering imaging tests that would be done at a facility he owns or leases.

The Advanced Diagnostic Ultrasound in Microgravity (ADUM) project is a U.S. government-funded study investigating strategies for applying diagnostic telemedicine to space. The Principal Investigator is Scott Dulchavsky, Chairman of Surgery at the Henry Ford Health System. This study was the first formal experiment to examine the use of ultrasound in microgravity encompassing musculoskeletal, heart, lung, abdominal, pelvic, dental, and orbital scans. Ultrasound is the only medical imaging device currently available on board the International Space Station. In addition, the lack of physician expertise on board the ISS makes diagnosis of medical conditions challenging. Ultrasound may have direct application for the evaluation and diagnosis of hundreds of medical conditions and is of interest for treating exploration crews. The telemedicine strategies investigated by this project has widespread application on Earth in emergency and rural care situations. Ultrasound images from space from a variety of body regions have been shown to be of diagnostic quality and non-expert operators were easily trained in ultrasound skills. This work has been expanded to include professional Football, Baseball, and Ice Hockey teams as well as the Winter and Summer Olympic Games in collaboration with investigators such as Marnix Van Holsbeeck. Dr. Dulchavsky has also led an innovative pilot study to expand comprehensive ultrasound education to basic science medical students at the Wayne State University School of Medicine. This trial has been shown to be a success with over 82 percent of students agreeing or strongly agreeing that their educational experience with the lightweight ultrasound technology education was positive. This technology is now being taught to medical students in their clinical clerkships.

<span class="mw-page-title-main">Epiphan Video</span> Audiovisual equipment manufacturer

Epiphan Video, also known as Epiphan, is a privately held audiovisual equipment manufacturer. It is headquartered in Ottawa, Ontario, Canada with offices in Palo Alto and San Jose, California.

<span class="mw-page-title-main">Coronary CT angiography</span> Use of computed tomography angiography to assess the coronary arteries of the heart

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Cardiac imaging refers to minimally invasive imaging of the heart using ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), or nuclear medicine (NM) imaging with PET or SPECT. These cardiac techniques are otherwise referred to as echocardiography, Cardiac MRI, Cardiac CT, Cardiac PET and Cardiac SPECT including myocardial perfusion imaging.

Prehospital ultrasound is the specialized application of ultrasound by physicians and other emergency medical services (EMS) to guide immediate care and treatment procedures. Like conventional ultrasound, it is a device that produces cyclic sound pressure to penetrate a medium and reveal details about the inner structure of the medium.

<span class="mw-page-title-main">Doppler ultrasonography</span> Ultrasound imaging of the movement of tissues and body fluids using the Doppler effect

Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids, and their relative velocity to the probe. By calculating the frequency shift of a particular sample volume, for example, flow in an artery or a jet of blood flow over a heart valve, its speed and direction can be determined and visualized.

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